NPI age
9 years
Enumerated 2016-10-04
● Active Type 2 · Organization
Meridian Physical Medicine
Meridian Physical Medicine is 1 of 658 nurse practitioner organizations in Idaho.
Primary specialty
Nurse Practitioner
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Runyan
Vice President
Last NPPES update
2016-10-04
Source: monthly bulk 2026-05
How this organization compares
Across 658 active nurse practitioner providers in Idaho.
NPI age
9 years
≈ at median (8 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2016 → 2026
2016-10Enumerated in NPPES
2016
2026
Where they practice
Primary practice location
2016 S Eagle Rd, Suite B
Meridian, ID 836426707
Mailing address
2016 S Eagle Rd, Suite B
Meridian, ID 836426707
Authorized official
Makayla Runyan
Vice President
📞 2088876810
Individual providers at this organization
4 individual providers on file at this primary practice address.
- Justin Griffin, DC Chiropractor NPI 1245201524
- Rebecca Kent Nurse Practitioner NPI 1770119422
- Shaun Mar, DC Chiropractor NPI 1952807836
- Sara Rose Massage Therapist NPI 1770989238
Specialties
-
Nurse Practitioner Primary(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1790053338 | NPI |
Practice context
Multi-provider organization. 4 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.